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Home My WebLink About06-15-2020 Septic Compliance Cert.Mailing Address P.O. Box 66 Crystal Bay, MN 55323 Street Address Certificate of Compliance 2750 Kelly Parkway Orono, MN 55356 Inspection Form Phone: 952-249-4600 Fax: 952-249-4616 Website: www.ci.orono.mn.us New Subsurface Sewage Treatment Systems (SSTS) Inspection results based on Minnesota Pollution Control Agency (MPCA) requirements and attached forms System status on date 06/15/2020 XD Compliant — Certificate of Compliance ❑ Noncompliant — Notice of Noncompliance Valid for 5 years from report date (See Upgrade Requirements on page 3.) Reason(s) for noncompliance (check all applicable) ❑ Impact on Public Health (Compliance Component #1) — Imminent threat to public health and safety ❑ Other Compliance Conditions (Compliance Component #3) — Imminent threat to public health and safety ❑ Tank Integrity (Compliance Component #2) — Failing to protect groundwater ❑ Other Compliance Conditions (Compliance Component #3) — Failing to protect groundwater ❑ Soil Separation (Compliance Component #4) — Failing to protect groundwater ❑ Operating permit/monitoring plan requirements (Compliance Component #5) — Noncompliant Property Information Property address: 4154 Deborah Drive Property owner: or Owner's representative: Local regulatory authority Brief system description: Certification Parcel ID# or Sec/Twp/Range: Reason for inspection: New instalation Owner's phone: Kevin Barthel Representative phone: 612-919-0112 City of Orono Regulatory authority phone: 952-249-4600 Comments orrecommendations: I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate maintenance, or future water usage. Inspector name: Roger Peitso Business name: Inspector signature: Necessary or Locally Required Attachments ® Soil boring logs ® System/As-built drawing ❑ Other information (list): Certification number: C6683 License number: Phone number: 952-249-4625 Page 1 of 3 Property address: 315 Old Crystal Bay Road Northt Inspector initials/Date: RLP 06/15/2020 (mm/dd/yyyy) 1. Impact on Public Health — Compliance component #1 of 5 Compliance criteria: Verification method(s): System discharges sewage to the ❑ Yes ® No ❑ Searched for surface outlet round surface. ❑ Searched for seeping in yard/backup in home System discharges sewage to drain ❑ Yes ® No ❑ Excessive ponding in soil system/D-boxes the or surface waters. ❑ Homeowner testimony (See Comments/Explanation) System causes sewage backup into ❑ Yes ® No ❑ "Black soil" above soil dispersal system dwelling or establishment. ❑ System requires "emergency" pumping Any "yes" answer above indicates the ❑ Performed dye test system is an imminent threat to public ❑ Unable to verify (See Comments/Explanation) health and safety, ❑ Other methods not listed (See Comments/Explanation) Comments/Explanation: New Installation 2. Tank Integrity — Compliance component #2 of 5 Compliance criteria: Verification method(s): System consists of a seepage pit, ❑ Yes ® No cesspool, drywell, or leaching pit. Seepage pits meeting 7080.2550 may be compliant if allowed in local ordinance. Sewage tank(s) leak below their ❑ Yes fVl No designed operating depth. If yes, which sewage tank(s) leaks: Any "yes" answer above indicates the system is failing to protect groundwater. Comments/Explanation: Inspected installation of new tanks ❑ Probed tank(s) bottom ❑ Examined construction records ❑ Examined Tank Integrity Form (Attach) ❑ Observed liquid level below operating depth ❑ Examined empty (pumped) tanks(s) ❑ Probed outside tank(s) for "black soil" ❑ Unable to verify (See Comments/Explanation) ❑ Other methods not listed (See Comments/Explanation) 3. Other Compliance Conditions — Compliance component #3 of 5 a. Maintenance hole covers are damaged, cracked, unsecured, or appear to be structurally unsound. ❑ Yes* ® No ❑ Unknown b. Other issues (electrical hazards, etc.) to immediately and adversely impact public health or safety. ❑ Yes* ® No ❑ Unknown *System is an imminent threat to public health and safety. Explain: c. System is non -protective of ground water for other conditions as determined by inspector. ❑ Yes* ® No *System is failing to protect groundwater. Explain: Page 2of3 Property address: 315 Old Crystal Bay Road North 4. Soil Date of installation: In — Compliance component #4 of 5 09/20/2019 ❑ Unknown (mm/dd/yyyy) Shoreland/Wellhead protection/Food beverage ❑ Yes ❑ No lodging? criteria: For systems built prior to April 1, 1996, and ❑ Yes ❑ No not located in Shoreland or Wellhead Protection Area or not serving a food, beverage or lodging establishment: Drainfield has at least a two -foot vertical separation distance from periodically saturated soil or bedrock. Non-performance systems built April 1, ® Yes ❑ No 1996, or later or for non-performance systems located in Shoreland or Wellhead Protection Areas or serving a food, beverage, or lodging establishment: Drainfield has a three-foot vertical separation distance from periodically saturated soil or bedrock.* "Experimental, "Other, or "Performance" ❑ Yes ❑ No systems built under pre -2008 Rules; Type IV or V systems built under 2008 Rules (7080. 2350 or 7080.2400 (Advanced Inspector License required) Drainfield meets the designed vertical separation distance from periodically saturated soil or bedrock. Any "no" answer above indicates the system is failing to protect groundwater. Inspector initials/Date: RLP 1 06/15/2020 (mm/dd/yyyy) Verification method(s): Soil observation does not expire. Previous soil observations by two independent parties are sufficient, unless site conditions have been altered or local requirements differ. ❑ Conducted soil observation(s) (Attach boring logs) XI Two previous verifications (Attach boring logs) ❑ Not applicable (Holding tank(s), no drainfield) ❑ Unable to verify (See Comments/Explanation) ❑ Other (See Comments/Explanation) Comments/Explanation: Benchmark 100' Top of slab foundation Indicate depths or elevations A. Bottom of distribution media 1 81.7 78.7 C. System separation 1 3 M 3 5. Operating Permit and Nitrogen BMP* — Compliance component #5 of 5 ® Not applicable Is the system operated under an Operating Permit? ❑ Yes ❑ No If "yes", A below is required Is the system required to employ a Nitrogen BMP? ❑ Yes ❑ No If "yes", B below is required BMP = Best Management Practice(s) specified in the system design If the answer to both questions is "no", this section does not need to be completed. Compliance criteria a. Operating Permit number: 171 Yes F1 No Have the Operating Permit requirements been met? b. Is the required nitrogen BMP in place and properly functioning? ❑ Yes ❑ No Any "no" answer indicates Noncompliance. Upgrade Requirements (Minn. Stat. § 115.55) An imminent threat to public health and safety (ITPHS) must be upgraded, replaced, or its use discontinued within ten months of receipt of this notice. If the system is failing to protect ground water, the system must be upgraded, replaced, or its use discontinued within three years of receipt of this notice. If an existing system is not failing as defined in law, and has at least two feet of design soil separation, then the system need not be upgraded, repaired, replaced, or its use discontinued. This provision does not apply to systems in shoreland areas, Wellhead Protection Areas, or those used in connection with food, beverage, and lodging establishments as defined in law. Page 3of3 4-oN� City of Orono Septic Asbuilt Form 4'is11oae Address: 415 Debrah Drive Building Use: sm Installer: Patnode Brothers Inc License # LIM Date: 6�L1�2II2t] Septic Tanks: 1-12501-1000 Pump Tank: 1-1250 Date Finaled: 6-15-2020 Bedrooms # 5 System Type: [X I E] II E] III a Mound [—] Trenches ❑ Pressure Bed ❑• Other Draw detailed diagram with measurements indicating distances to tank Risers. Use two(2) points from a permanent structure. Show locations of drop Boxes and length of trenches ,9 o E 78 kA m zo O A I B 1 2 1(ss, •73 3 85' 4 5 6 95 7o' 13' ' r \c4. i+ 8 9 10 11 V 12 0 ,9 o E 78 kA m zo O A I B 1 2 1(ss, •73 3 85' 4 5 6 95 7o' 13' ' 7 8 9 10 11 12 Property Owmer / project: Property Address / PID: Parent mates: landscape position: soil survey snap units: Soil Observation Log www.SeptieResource.com vers 12.4 Nora Sillerud 415 Deborah Dr., Orono Date 8/5/2019 FJ Till [} Outwash [} tacustrine ❑ Alluvium ❑ Organic ❑ Bedrock Summit [} Shoulder ❑ Side slope El Toe slope KkC slope 8 % direction- downhill PI Boring ❑ Pit Elevation 92.2 Depth to SHWT 30" nenth (inl Texhire fraemeat % matrix color redox color consistence trade shave 0 - 8 fill soil loam 8- 16 16-26 loam clay loam I OYR 3/2 l OYR 413 Friable Firm Weak Moderate Single grain Prismatic 26 - 30 sandy loam LORE 5/3 Friable Weak Granular 30-36 clay loam 10YR 5/3 10YR 6/8,10YR7/l Finn Moderate Prismatic Comments: r S Deborah DfOrono Soil Log #2 ❑ pit Elevation 92.8 Depth to SHWT 3V"epth (in) fi-agment % matrix color redox color consistence grade shape 0-12 loam 10YR 3/2 Friable Weak Granular 12-30 clay loam I OYR 4/3 Finn Moderate Prismatic 30-36 clay loam I OYR 4/3 10YR 6/8, I OYR7/1 Firm Moderate Prismatic 36-42 clay learn I OYR 6/3 IOYR6/8,1 OYR7/1 Firm Moderate Prismatic 415 Deborah Dr., Orono Soil Log #3 PIT 18"DEEP ❑ Boring 0 pit Elevation 78.4 Depth to SHWT 26" Depth (in) Texture fragment % matrix color redox color consistence grade shape 0-16 loam I OYR 3/2 Friable Weak Granular 16-20 loam I OYR 4/3 Friable Weak Granular 20-26 clay loam 10YR 5/3 Finn Moderate Prismatic 26-32 clay loam I OYR 5/3 IOYR 6/8, IOYR 7/1 Firm Moderate Prismatic 1 hereby certify this work was completed in accordance with AN 7080 and any local reqs. 3,q Designer Signature Company License borah Dr,, Orono ❑ Boring rDefpthn) Texture 0 - 12 loam 12 - 22 clay loam 22 - 30 clay loam ❑ Pit fragment % Soil Log #4 Elevation Depth to SHWT matrix color redox color consistence l OYR 3/2 Friable l OYR 4/3 Firm I OYR 5/3 J OYR 6/B, I OYR7/I Firm grade Weak Moderate Moderate shape Granular prismatic prismatic 415 Deborah Dr, Orono PIT 18" DEEP ❑ Boring Depth (in) Texture 0-18 loam Pit fragment % Soil Log #5 Elevation 78.3 matrix color redox color l OYR 3/2 Depth to SHWT consistence Friable 22" grade Weak shape Granular 18-22 clay loam I OYR 4/2 Firm Moderate prismatic 22-30 clay loam l OYR 5/3 10YR6/8,10YR7l1 Finn Moderate prismatic I hereby cert fy this work was completed in accordance with AN 7080 and any local reqs. ate' C6 Designer Signature Company License #